IPOACUSIA NEUROSENSORIALE E DANNO ISCHEMICO. MESSA A PUNTO DI UN MODELLO ANIMALE PER VALUTARNE GLI EFFETTI VASCOLARI E OSSIDATIVI.

Hearing impairment is an increasingly common disease. In Italy deaf people are about seven million, including half a million adults with disabling hearing loss and over one thousand births per year with congenital deafness. This causes difficulty in integration in society for adults and prevents the language acquisition for children (Fekete, 1999). As hearing loss has high social costs, the expectation for the development of new treatments is extensive and diseases leading to hearing damage are increasingly studied from clinic and base research. Hearing loss (HL) can have genetic causes, can be associated with aging or exposure to noise or ototoxic substances, and the aetiology can be attributed to vascular injury, trauma, tumours, infections or autoimmune response. All of these factors could be ascribed to alterations in cochlear microcirculation resulting in hypoxia. This condition can damage cochlear hair cells and neurons possibly leading to HL. Hypoxia and ischemia can then be identified as possible factors contributing to the aetiology of deafness, but they have not been experimentally studied yet. The purpose of this work is to develop animal models of ischemia and infarction suitable for the study of cochlear vascular damage, and to characterize them with electrophysiology and gene/protein expression analyses. For this reason it was decided to monitor the effects of ischemia in thrombosis mimicked by complete temporary carotid occlusion, and in stroke mimicked by incomplete permanent left coronary artery. In particular this study focused on the analysis of: organ of Corti and spiral ganglion structures, coagulation, oxidative stress and apoptosis. A further aim was to compare these models with other models of ototoxic damage, such as noise and cisplatin. These models are both characterized for electrophysiology, oxidative stress and apoptosis, but the possible involvement of vascular damage has not been investigated yet. This comparison helped us to characterize the new models of vascular injury in the oxidation and apoptosis expression patterns. In our models, both infarction and ischemia cause a small but significant hearing loss, localized at the cochlear apex. Furthermore, there is a slight induction of the coagulation cascade, both in procoagulant and anticoagulant part, and an activation of JNK, that may lead to cell survival. In addition, only in the carotid ischemia the cuticular plate of outer hair cells is damaged. Even noise and cisplatin cause vascular damage, but while in noise-treated animals the coagulation genes show only an mRNA expression increase, after cisplatin administration an mRNA and protein increase of the tissue factor is detected, which leads to the coagulation cascade activation. In the ischemic models we did not detect any apoptosis activation, while in the other models we noticed opposite reactions: in noise there is an increased transcription of the anti-apoptotic genes that leads to cell survival, while cisplatin activates pro-apoptotic factors. The activation of apoptosis is documented in literature and is confirmed in both conditions by OHC loss detected in histological sections, which leads to a more severe deafness than in the ischemia models. In conclusion, the two models of ischemia developed are suitable for the study of cochlear vascular damage, as they produce a slight hearing loss and give modifications in coagulative, oxidative and apoptotic factors gene expression. Furthermore, the comparison with two other widely used models allowed us to specify the pathways involved. We can therefore say that all types of damage taken into consideration act on the inner ear with vascular damage and oxidative mechanisms

Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

Funder: European Society of Intensive Care Medicine; doi: http://dx.doi.org/10.13039/501100013347Funder: Flemish Society for Critical Care NursesAbstract: Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat

Correction to: Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

The original version of this article unfortunately contained a mistake

Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

Funder: European Society of Intensive Care Medicine; doi: http://dx.doi.org/10.13039/501100013347Funder: Flemish Society for Critical Care NursesAbstract: Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat

Search for gravitational-lensing signatures in the full third observing run of the LIGO-Virgo network

Gravitational lensing by massive objects along the line of sight to the source causes distortions of gravitational wave-signals; such distortions may reveal information about fundamental physics, cosmology and astrophysics. In this work, we have extended the search for lensing signatures to all binary black hole events from the third observing run of the LIGO--Virgo network. We search for repeated signals from strong lensing by 1) performing targeted searches for subthreshold signals, 2) calculating the degree of overlap amongst the intrinsic parameters and sky location of pairs of signals, 3) comparing the similarities of the spectrograms amongst pairs of signals, and 4) performing dual-signal Bayesian analysis that takes into account selection effects and astrophysical knowledge. We also search for distortions to the gravitational waveform caused by 1) frequency-independent phase shifts in strongly lensed images, and 2) frequency-dependent modulation of the amplitude and phase due to point masses. None of these searches yields significant evidence for lensing. Finally, we use the non-detection of gravitational-wave lensing to constrain the lensing rate based on the latest merger-rate estimates and the fraction of dark matter composed of compact objects

Correlation of adverse effects of cisplatin administration in patients affected by solid tumours: A retrospective evaluation

Cisplatin is the most common antineoplastic drug used for the therapy of solid tumours. To date, researchers have focused on the dosage to be administered for each specific tumour, mainly considering the local adverse effects. The aim of this study was to correlate the severity of the adverse effects with: i) the dosage of cisplatin; ii) the specific site of the tumour; iii) the association with other drugs; and iv) the symptoms. We analysed data from 123 patients with 11 different tumour classes undergoing therapy from 2007 to 2008 at St. Anna Hospital (Ferrara, Italy), using the Spearman non-parametric correlation index. Even though significant correlations were found among the variables, the overall results showed that the main factor influencing the severity of the adverse effects was the dosage of cisplatin administered

Morphological and functional structure of the inner ear: Its relation to M\ue9ni\ue8re's disease

M\ue9ni\ue8re's disease is a disabling disorder presenting with crises of aural fullness, tinnitus, hearing loss and vertigo. The hallmark of the pathology is a labyrinthine hydrops, but its pathogenesis remains unclear. This unknown aetiology explains the lack of a good pharmacological treatment. Here, we wish to evaluate the different parameters that can be involved in the progression of the disease, focusing on vascular disorders, production of reactive oxygen species and the relationship between the endolymph and haematic perfusion. We know that the blood supply must be adequate to guarantee the establishment of the endocochlear potential and the production of endolymph, so aberrant microcirculation may be an aetiological factor for M\ue9ni\ue8 re's disease. \ua9 2012 Informa Healthcare